Section 1 - Virtual School Enrollment Type
You are applying for full-time enrollment into this program  
Section 2 - Student information
Student ID: Birth date: (format: mm/dd/yyyy)
Note Please keep in mind that a student ID is a Lee School District assigned identifier. If this identifier is not available, then skip this section and go to Section 3 below.
Section 3 - Student information
*Last Name: *First Name:
Middle Name: *Birth date: (format: mm/dd/yyyy)
Current Home Address
*Street: Apartment/Unit:
*City: *Zip Code:
*Student Telephone: Telephone Type: Cell Work Home
Student Email address:
Note An asterisk * indicates that the user must provide the requested data
Section 4 - Last school attended and grade applying for
*Name of the school: *County:
*School District: *State:
Grade applying for in Lee County
*  
Note An asterisk * indicates that the user must provide the requested data
Section 5 - Parent/Guardian information
*Last Name: *First Name:
*Parent Telephone: Telephone Type: Cell Work Home
*Parent Email address:
*Relation to the student: Father Mother Guardian/other
Note An asterisk * indicates that the user must provide the requested data
Section 6 - Preliminary eligibility questions (*Please answer all questions)
  1. Is the student currently enrolled at a Lee County Public School? - Yes - No
  2. Is the student enrolled in an Exceptional Student Education - ESE program? - Yes - No
  3. Is the student enrolled as a home school student? - Yes - No
  4. Have you ever been enrolled in any virtual course before? - Yes - No
    If yes, please enter the name of the virtual school and when you were enrolled below.
         When:
  5. What is your reason for applying to LVIP?
  6. Are you a Lee County resident? - Yes - No
Note An asterisk * indicates that the user must provide the requested data